HEALTH CARE/Joan Retsinas

A Day With a Sick Mexican (or Pakistani or Ethiopian or Bosnian ...)

The 2004 movie, A Day Without a Mexican, alarmed the nation’s non-Mexican employers: many restaurants, landscape services, factories, hotels, Wal-Marts and their ilk would close. Affluent families would lose the workers who make their households hum. Construction sites would idle; crops would rot. The Urban Institute estimates that immigrants, who comprise 11% of the population, comprise 20% of the low-wage workforce.

The movie’s message was clear and alarmist: The USA needs its immigrants.

But we need healthy immigrants.

States have lost sight of that need.

For states, this is slash-the-budget time. The states that face budgets written in red ink seek to “spread the pain,” which generally means “bash the poor.” After all, the poor, who sop up public heath care, transportation, education, housing and welfare, must accept responsibility for closing the budget-hole. Besides, unlike wealthier constituents, the poor don’t contribute to campaigns.

Of the poor, the most bashable people are illegal immigrants. Understandably, we have no firm statistics. Those workers struggle to stay below the statistical radar. But we know that millions don’t have green cards. These workers will not protest the most draconian cuts. Any protest will earn them one-way tickets back to their native hellholes.

The heftiest cut is health insurance. States have no responsibility to insure the care of people here illegally. So states, in their zeal to slash Medicaid, will target not only people who fall afoul of narrow eligibility guidelines, but people here without documentation. Rhode Island is a case in point. Its budget looks like a galactic black hole. So politicos have cut Medicaid spending (although the state’s part-time legislators continue to authorize free health insurance for themselves). And politicos have nixed care for “illegal aliens”—a sorry nomenclature that evokes more science fiction evil.

It’s time for a sequel to A Day Without a Mexican. How about A Day with a Sick Mexican (or Pakistani or Ethiopian or Bosnian ...)”.

This movie has a villain: disease. The people who prop up the service sector are potential carriers of everything infectious. Pneumonia, influenza, measles, hepatitis—those diseases don’t select for green cards. The diseases spread across restaurant kitchens, supermarket counters, laundries. Since undocumented people live with documented people (many people came here legally and stayed when their visas expired), the potential for epidemics rises. As vaccination clinics turn away people without green cards, we may see outbreaks of tuberculosis, whooping cough, maybe polio. This movie, with lots of painful deaths, might be a blockbuster. The reality would be grim.

As for the noninfectious diseases—like asthma, diabetes, heart disease, arthritis, Parkinson’s—we all risk getting them, especially as we age. Immigrants, regardless of documentation, have the same risks. Ignoring their health needs will not just lower the quality of their lives—it will also lower the overall productivity of the nation. Our nation’s gross domestic product relies on workers’ productivity. An ailing workforce will squash economic growth.

Nativist politicians pushing xenophobia want to discourage Emma Lazarus’ “tired, poor huddled masses yearning to breathe free” from paying exorbitant fees and risking death to arrive here. But denying them health care won’t do it. Immigrants come here for a better life; they are not coming for health care. Indeed, the ones who make it to the United States illegally tend to be strong, young and healthy, or they wouldn’t survive the trek.

Nor will illegal immigrants, banned from hospitals and clinics, leave the US. The person who can’t get chemotherapy in the US is not likely to get it in Mexico, Pakistan, Ethiopia or Bosnia. The would-be patient will stay here, getting sicker, perhaps making others (including non-immigrant co-workers and customers) sicker.

We have a workforce dependent on immigrants, legal and not. Those workers will get sick. Ignoring them will only lower the overall health of the nation as a whole—our body politick.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email

From The Progressive Populist, August 15, 2008

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